Hearts meant for transplants end up in trash

Jan 18, 2013, 12.33AM ISTTNN[ Pushpa Narayan ]

CHENNAI: Thousands of people die of end-stage heart disease in the country every year. Yet, 250 hearts donated by the deceased in Tamil Nadu were discarded without being transplanted, government data shows.

The valves were removed and stored, but the hearts were either treated as medical waste or left in the body. Heart transplant is the only option for patients with end-stage heart failure or irreparable coronary artery disease. During this procedure, doctors replace the ailing heart with a healthy one from a brain dead patient.

In several countries, patients are put on assisted devices to keep them alive till the transplant because there aren't enough hearts. In India, only Chennai, Hyderabad, Delhi, Bangalore, Kochi and Visakhapatnam have done heart transplants. Many cities like Mumbai have not done a heart transplant in several years simply because they don't have a programme to retrieve organs from the brain dead. Poor co-ordination among transplant surgeons and lack of awareness among patients and cardiologists make it worse.

Chennai has one of the oldest surviving heart transplant patients in the country and the city leads in the number of heart transplants. However, only 17% of hearts received were used by surgeons in the state last year, said Tamil Nadu organ transplant registry convener Dr J Amalorpavanthan. The registry received organs from 306 brain dead patients till December 2012. It allotted organs to several hospitals based on a waiting list. While 280 livers and 563 kidneys were harvested, only 52 hearts and 13 lungs were retrieved for transplant.

Senior transplant surgeon Dr K M Cherian said that often organs that seem fit for transplant based on the age and health of the donor cannot be used because the harvest is delayed. "The heart is always the last to be harvested. There are times when liver surgeons want to do pathological tests to check if the organ is viable. By the time they harvest the organ, the heart becomes unfit for transplant. This has happened to us at least thrice." Lack of awareness big transplant hitch

Chennai: Heart transplant surgeon Dr Madhu Shankar said lack of awareness among cardiologists and patients was a major reason. "Patients refuse transplant because they are scared. In the case of kidney failure, the patient has to undergo dialysis and for liver disease, jaundice can make life hell. So they agree to transplants. But most heart failure patients don't suffer till the condition gets really serious. They are kept on medicines and advised bed rest," he said. "It is important for cardiologists to tell them their condition would get worse if they don't undergo a transplant. For patients with heart failure, only 25% survive for more than a year without transplant," he said.

Delhi-based Dr Sujay Shad,director of heart lung transplants and chief cardiac surgeon at Ganga Ram Hospital, says many patients don't understand that heart failure can be worse than most cancers. "A major fault lies with the medical fraternity. It takes time to explain heart failure to the patient and most doctors spend not more than a few minutes. Many would rather send the patient home happy and blissfully ignorant of his condition after prescribing a pill," he said. Dr Shad said he received offers for seven hearts last year, but could not find an appropriate match. "There are enough cardiac surgeons in the country with the right expertise. Cost is not a factor. A heart transplant costs Rs 14 lakh, including the year-long post-op care," he said. In comparison, a liver transplant costs up to Rs 45 lakh.